Gastrointestinal mucormycosis: report of two cases
Abstract: Mucormycosis is an infection caused by Zygomycetes fungi of the Mucorales order, usually associated with high morbidity and mortality. It is considered an opportunistic mycosis, affecting mainly immunocompromised patients (prolonged use of corticosteroids, decompensated type 2 di...
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| Formato: | Artículo revista |
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Universidad Nacional Córdoba. Facultad de Ciencias Médicas. Secretaria de Ciencia y Tecnología
2021
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| Acceso en línea: | https://revistas.unc.edu.ar/index.php/med/article/view/35010 |
| Aporte de: |
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I10-R327-article-35010 |
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Universidad Nacional de Córdoba |
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I-10 |
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R-327 |
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Revista de la Facultad de Ciencias Médicas de Córdoba |
| format |
Artículo revista |
| topic |
mucormycosis adomen acute hyphae fungus infections mucormicosis abdomen agudo hifa hinfecciones fúngicas |
| spellingShingle |
mucormycosis adomen acute hyphae fungus infections mucormicosis abdomen agudo hifa hinfecciones fúngicas Perez , C Masciarelli , L Aguado , G Ferraris , L Gonzalez , C Gastrointestinal mucormycosis: report of two cases |
| topic_facet |
mucormycosis adomen acute hyphae fungus infections mucormicosis abdomen agudo hifa hinfecciones fúngicas |
| author |
Perez , C Masciarelli , L Aguado , G Ferraris , L Gonzalez , C |
| author_facet |
Perez , C Masciarelli , L Aguado , G Ferraris , L Gonzalez , C |
| author_sort |
Perez , C |
| title |
Gastrointestinal mucormycosis: report of two cases |
| title_short |
Gastrointestinal mucormycosis: report of two cases |
| title_full |
Gastrointestinal mucormycosis: report of two cases |
| title_fullStr |
Gastrointestinal mucormycosis: report of two cases |
| title_full_unstemmed |
Gastrointestinal mucormycosis: report of two cases |
| title_sort |
gastrointestinal mucormycosis: report of two cases |
| description |
Abstract:
Mucormycosis is an infection caused by Zygomycetes fungi of the Mucorales order, usually associated with high morbidity and mortality. It is considered an opportunistic mycosis, affecting mainly immunocompromised patients (prolonged use of corticosteroids, decompensated type 2 diabetes, hematological neoplasms, transplants, HIV, trauma and burns). Among the forms of presentation are rhinoorbitocerebral, pulmonary, cutaneous, disseminated and gastrointestinal, the latter being very rare. In the gastrointestinal form, the stomach is the most frequently affected site, followed by the colon and ileum, and it usually presents as gastric, appendicular, colonic or ileal masses or perforations, with possible peritonitis and sepsis, associated in some cases with massive gastrointestinal bleeding. The symptoms are not specific, which means that this pathology requires a high index of suspicion and the diagnosis is therefore generally delayed.
The objective of this presentation is to report two cases of gastrointestinal mucormycosis.
One of the cases corresponds to a patient who, after a prolonged hospitalization due to an accident, presented an acute abdomen, with multiple intestinal perforations. After a torpid course, he died without known cause of said perforations, for which an autopsy was performed.
The other patient, with a history of prolonged treatment with glucocorticoids and intercurrent COVID19 infection, presented with lower gastrointestinal bleeding and perforated acute abdomen, for which a subtotal colectomy was performed, with suspected diagnosis of Crohn's disease due to the distribution and characteristics of the lesions.
Microscopically, in both cases, ulcers and perforations were observed in which the presence of thick, asept and branched hyphae stood out, characteristics compatible with mucormycetes that were positive with PAS staining.
It is worth noting the need for a high index of suspicion and to consider this pathology as a possible differential diagnosis in view of the non-specificity of the signs and symptoms, carrying out the pertinent studies and thus arriving at a diagnosis and treatment that prevents rapid evolution of this pathology that behaves aggressively |
| publisher |
Universidad Nacional Córdoba. Facultad de Ciencias Médicas. Secretaria de Ciencia y Tecnología |
| publishDate |
2021 |
| url |
https://revistas.unc.edu.ar/index.php/med/article/view/35010 |
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2024-09-03T21:02:56Z |
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2024-09-03T21:02:56Z |
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I10-R327-article-350102024-04-15T16:19:09Z Gastrointestinal mucormycosis: report of two cases Mucormicosis gastrointestinal: reporte de dos casos Perez , C Masciarelli , L Aguado , G Ferraris , L Gonzalez , C mucormycosis adomen acute hyphae fungus infections mucormicosis abdomen agudo hifa hinfecciones fúngicas Abstract: Mucormycosis is an infection caused by Zygomycetes fungi of the Mucorales order, usually associated with high morbidity and mortality. It is considered an opportunistic mycosis, affecting mainly immunocompromised patients (prolonged use of corticosteroids, decompensated type 2 diabetes, hematological neoplasms, transplants, HIV, trauma and burns). Among the forms of presentation are rhinoorbitocerebral, pulmonary, cutaneous, disseminated and gastrointestinal, the latter being very rare. In the gastrointestinal form, the stomach is the most frequently affected site, followed by the colon and ileum, and it usually presents as gastric, appendicular, colonic or ileal masses or perforations, with possible peritonitis and sepsis, associated in some cases with massive gastrointestinal bleeding. The symptoms are not specific, which means that this pathology requires a high index of suspicion and the diagnosis is therefore generally delayed. The objective of this presentation is to report two cases of gastrointestinal mucormycosis. One of the cases corresponds to a patient who, after a prolonged hospitalization due to an accident, presented an acute abdomen, with multiple intestinal perforations. After a torpid course, he died without known cause of said perforations, for which an autopsy was performed. The other patient, with a history of prolonged treatment with glucocorticoids and intercurrent COVID19 infection, presented with lower gastrointestinal bleeding and perforated acute abdomen, for which a subtotal colectomy was performed, with suspected diagnosis of Crohn's disease due to the distribution and characteristics of the lesions. Microscopically, in both cases, ulcers and perforations were observed in which the presence of thick, asept and branched hyphae stood out, characteristics compatible with mucormycetes that were positive with PAS staining. It is worth noting the need for a high index of suspicion and to consider this pathology as a possible differential diagnosis in view of the non-specificity of the signs and symptoms, carrying out the pertinent studies and thus arriving at a diagnosis and treatment that prevents rapid evolution of this pathology that behaves aggressively Resumen: La mucormicosis es una infección producida por hongos Zygomicetos del orden Mucorales habitualmente asociada a una elevada morbimortalidad. Se considera una micosis oportunista, afectando principalmente a pacientes inmunocomprometidos (uso prolongado de corticoides, diabetes tipo 2 descompensada, neoplasias hematológicas, transplantes, HIV, traumatismos y quemaduras). Dentro de las formas de presentación se encuentran la rinoórbitocerebral, la pulmonar, la cutánea, la diseminada y la gastrointestinal, siendo esta última muy poco frecuente. De la forma gastrointestinal el estómago es el sitio afectado con mayor frecuencia, seguido del colon e íleon, y se suele presentar como masas o perforaciones a nivel gástrico, apendicular, colónico o ileal, con posible peritonitis y sepsis, asociado en algunos casos a sangrado gastrointestinal masivo. La clínica no es específica, lo cual implica que esta patología requiere de un alto índice de sospecha y el diagnóstico en general es tardío. El objetivo de esta presentación es reportar dos casos de mucormicosis de localización gastrointestinal. Uno de los casos corresponde a un paciente, que tras cursar una prolongada hospitalización posterior a un accidente, presentó un cuadro de abdomen agudo, con múltiples perforaciones intestinales. Tras un curso tórpido falleció sin causa primera conocida de dichas perforaciones, por lo que se realizó la autopsia. El otro paciente, con antecedentes de tratamiento prolongado con glucocorticoides e infección intercurrente por COVID19, presentó un cuadro de hemorragia digestiva baja y abdomen agudo perforativo, por lo que se le practicó una colectomía subtotal, con sospecha diagnóstica de enfermedad de Crohn por la distribución y características de las lesiones. Microscópicamente, en ambos casos, se observaron úlceras y perforaciones en las que se destacaba la presencia de hifas gruesas, aseptadas y ramificadas, características compatibles con mucormicetos que resultaron positivas con la tinción de PAS. Vale remarcar la necesidad de un alto índice de sospecha y de barajar esta patología como posible diagnóstico diferencial debido a la inespecificidad de los signos y síntomas para luego llevar adelante los estudios pertinentes y de esa manera arribar a un diagnóstico y tratamiento que impida la rápida evolución de esta patología de comportamiento agresivo. Universidad Nacional Córdoba. Facultad de Ciencias Médicas. Secretaria de Ciencia y Tecnología 2021-10-12 info:eu-repo/semantics/article info:eu-repo/semantics/publishedVersion texto texto texto https://revistas.unc.edu.ar/index.php/med/article/view/35010 Revista de la Facultad de Ciencias Médicas de Córdoba.; Vol. 78 No. Suplemento (2021): Suplemento JIC XXII Revista de la Facultad de Ciencias Médicas de Córdoba; Vol. 78 Núm. Suplemento (2021): Suplemento JIC XXII Revista da Faculdade de Ciências Médicas de Córdoba; v. 78 n. Suplemento (2021): Suplemento JIC XXII 1853-0605 0014-6722 http://creativecommons.org/licenses/by-nc/4.0 |